Haga Silje Marie, Drozd Filip, Brendryen Håvar, Slinning Kari
National Institute of Infant Mental Health, Center for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway.
JMIR Res Protoc. 2013 Aug 12;2(2):e29. doi: 10.2196/resprot.2659.
Currently, 10-15% of women giving birth suffer from symptoms of postpartum depression. Due to a lack of knowledge of this condition and the stigma associated with it, as well as few treatment options, a large proportion of postpartum women with depression remain untreated. Internet-based interventions have been found effective in treating depression, anxiety, phobias, and addictions. Hence, we developed such program ("Mamma Mia") with the aim of reducing the risk for postpartum depression and enhance subjective well-being. Mamma Mia is based on positive psychology, metacognitive therapy, and couples therapy. It starts in gestational week 22, and lasts until 6 months after birth. During pregnancy, Mamma Mia is delivered weekly (every Monday). After birth, Mamma Mia is delivered three times per week for six weeks. The remaining weeks, the program is delivered more sporadically. In total, Mamma Mia consists of 44 sessions. The program is individualized, interactive, and tunneled (ie, the user is guided through the program in a pre-determined manner).
The purpose of the present study was to pilot test the intervention in order to assess the feasibility and acceptance among program users.
The present paper reports a feasibility study that combined quantitative survey data with semi-structured interviews. Participants (N=103) were recruited via hospitals, well-baby clinics, and Facebook. Due to time constraint in completing the current study, our results were based on participation in one of the two phases: pregnancy or maternity. Participants in the pregnancy phase were surveyed 4 and 8 weeks after intervention enrollment, and participants in the postnatal phase were surveyed 2 and 4 weeks after intervention enrollment. The survey assessed perceived usefulness, ease-of-use, credibility, and unobtrusiveness. All measures were filled in by participants at both measurement occasions. Data were analyzed by running descriptives and frequencies with corresponding percentages. Binomial tests were carried out to investigate whether demographics differed significantly from a 50/50 distribution. Paired sample t tests were used to examine differences between time 1 and 2. Four participants were interviewed in the qualitative follow-up study, where they were given the opportunity to address and elaborate on similar aspects as assessed in the survey.
More than two-thirds of users found Mamma Mia to be of high quality and would recommend Mamma Mia to others. By far, most also found the amount of information and frequency of the intervention schedule to be appropriate. Mamma Mia was perceived as a user-friendly and credible intervention.
Overall, the user acceptance of Mamma Mia was good and our findings add to the feasibility of the program. The effect of Mamma Mia on depression and subjective well-being will be evaluated in a large randomized controlled trial, and if found to be effective, Mamma Mia could serve as a low-threshold prevention program.
目前，10%至15%的产妇患有产后抑郁症状。由于对这种疾病缺乏了解以及与之相关的污名，再加上治疗选择有限，很大一部分产后抑郁女性仍未得到治疗。基于互联网的干预措施已被证明对治疗抑郁症、焦虑症、恐惧症和成瘾有效。因此，我们开发了这样一个项目（“妈妈咪呀”），旨在降低产后抑郁风险并提高主观幸福感。“妈妈咪呀”基于积极心理学、元认知疗法和夫妻疗法。它从妊娠第22周开始，持续到产后6个月。在孕期，“妈妈咪呀”每周（每周一）提供一次。产后，“妈妈咪呀”每周提供三次，共六周。其余时间，该项目的提供则较为零散。“妈妈咪呀”总共包括44节课程。该项目是个性化、互动式且有引导的（即用户以预先确定的方式在项目中得到引导）。
本研究的目的是对该干预措施进行试点测试，以评估项目用户的可行性和接受度。
本文报告了一项将定量调查数据与半结构化访谈相结合的可行性研究。参与者（N = 103）通过医院、母婴诊所和脸书招募。由于完成当前研究的时间限制，我们的结果基于参与两个阶段之一：孕期或产后期。孕期阶段的参与者在干预登记后4周和8周接受调查，产后阶段的参与者在干预登记后2周和4周接受调查。该调查评估了感知有用性、易用性、可信度和不唐突性。所有测量指标均由参与者在两个测量时间点填写。通过运行描述性统计和频率以及相应百分比来分析数据。进行二项式检验以调查人口统计学特征是否与50/50分布有显著差异。配对样本t检验用于检查时间1和时间2之间的差异。在定性随访研究中对四名参与者进行了访谈，在访谈中他们有机会阐述和详细说明与调查中评估的类似方面。
超过三分之二的用户认为“妈妈咪呀”质量很高，并会向他人推荐“妈妈咪呀”。到目前为止，大多数人也认为信息数量和干预安排的频率是合适的。“妈妈咪呀”被认为是一个用户友好且可信的干预措施。
总体而言，用户对“妈妈咪呀”的接受度良好，我们的研究结果增加了该项目的可行性。“妈妈咪呀”对抑郁症和主观幸福感的影响将在一项大型随机对照试验中进行评估，如果被证明有效，“妈妈咪呀”可以作为一个低门槛预防项目。
